Laparoscopic total mesorectal excision combined with intersphincteric resection for ultra-low rectal cancer.
- Author:
Zhen-xu ZHOU
1
;
Xiao-feng ZHENG
;
Hua-yu SONG
;
Fei-zhao JIANG
;
Zhe-jin WANG
;
Zhi-gui ZUO
;
Hua-jie CAI
;
Xiao-jiao RUAN
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Aged, 80 and over; Anal Canal; surgery; Female; Follow-Up Studies; Humans; Laparoscopy; Male; Mesentery; surgery; Middle Aged; Rectal Neoplasms; surgery; Rectum; surgery; Retrospective Studies; Treatment Outcome
- From: Chinese Journal of Gastrointestinal Surgery 2011;14(6):440-442
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate clinical outcomes after laparoscopic total mesorectal excision (TME) combined with intersphincteric resection (ISR) for ultra-low rectal tumors.
METHODSClinical data of 36 patients with ultra-low rectal tumor undergoing laparoscopic TME combined with ISR were analyzed retrospectively.
RESULTSThe median distance from the inferior margin of the tumor to the anal verge was 3.4 (2.0-5.0) cm. There were 33 cases of well/moderately differentiated adenocarcinoma and 3 rectal malignant villous adenoma. There were 16 patients with stage I disease, 15 with stage II A, 3 with stage III A, and 1 with III B. Postoperatively, one patient developed stenosis at the end ileostomy and 3 anastomotic leakage. After a median follow-up of 16(4-49) months, one patient developed local recurrence at the anastomosis and one case died of liver metastasis. In the 19 patients who had a minimum follow-up of one year, the bowel movements frequency ranged from 1-4 times per day, and these patients were able to withhold defecation for more than 5 minutes.
CONCLUSIONSLaparoscopic TME combined with ISR can achieve oncologic clearance, sphincter preservation, and minimal invasiveness for ultra-lower rectal cancer. However, patients selection should be cautious.